1.1                          A bill for an act 
  1.2             relating to human services; allowing nursing 
  1.3             facilities exemption from Medicare certification under 
  1.4             certain circumstances; amending Minnesota Statutes 
  1.5             1998, section 256B.48, subdivision 6. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  Minnesota Statutes 1998, section 256B.48, 
  1.8   subdivision 6, is amended to read: 
  1.9      Subd. 6.  [MEDICARE CERTIFICATION.] (a)  [DEFINITION.] For 
  1.10  purposes of this subdivision, "nursing facility" means a nursing 
  1.11  facility that is certified as a skilled nursing facility or, 
  1.12  after September 30, 1990, a nursing facility licensed under 
  1.13  chapter 144A that is certified as a nursing facility.  
  1.14     (b)  [MEDICARE PARTICIPATION REQUIRED.] All nursing 
  1.15  facilities shall participate in Medicare part A and part B 
  1.16  unless, after submitting an application, Medicare certification 
  1.17  is denied by the federal health care financing administration.  
  1.18  Medicare review shall be conducted at the time of the annual 
  1.19  medical assistance review.  Charges for Medicare-covered 
  1.20  services provided to residents who are simultaneously eligible 
  1.21  for medical assistance and Medicare must be billed to Medicare 
  1.22  part A or part B before billing medical assistance.  Medical 
  1.23  assistance may be billed only for charges not reimbursed by 
  1.24  Medicare.  The commissioner may approve a request for an 
  1.25  exemption from Medicare certification if a nursing facility 
  2.1   meets the following criteria: 
  2.2      (1) the facility has had at least six months' experience 
  2.3   under the Medicare prospective payment system; and 
  2.4      (2) the facility can demonstrate losses under the Medicare 
  2.5   prospective payment system.  
  2.6      Facilities requesting an exemption from Medicare 
  2.7   certification may request that they not be certified for 
  2.8   Medicare for up to three years.  The commissioner must respond 
  2.9   within 30 days to a request for an exemption under this section. 
  2.10     (c)  [UNTIL SEPTEMBER 30, 1990.] Until September 30, 1990, 
  2.11  a nursing facility satisfies the requirements of paragraph (b) 
  2.12  if:  (1) at least 50 percent of the facility's beds that are 
  2.13  licensed under section 144A and certified as skilled nursing 
  2.14  beds under the medical assistance program are Medicare 
  2.15  certified; or (2) if a nursing facility's beds are licensed 
  2.16  under section 144A, and some are medical assistance certified as 
  2.17  skilled nursing beds and others are medical assistance certified 
  2.18  as intermediate care facility I beds, at least 50 percent of the 
  2.19  facility's total skilled nursing beds and intermediate care 
  2.20  facility I beds or 100 percent of its skilled nursing beds, 
  2.21  whichever is less, are Medicare certified. 
  2.22     (d)  [AFTER SEPTEMBER 30, 1990.] After September 30, 1990, 
  2.23  a nursing facility satisfies the requirements of paragraph (b) 
  2.24  if at least 50 percent of the facility's beds certified as 
  2.25  nursing facility beds under the medical assistance program are 
  2.26  Medicare certified. 
  2.27     (e)  [CONFLICT WITH MEDICARE DISTINCT PART REQUIREMENTS.] 
  2.28  At the request of a facility, the commissioner of human services 
  2.29  may reduce the 50 percent Medicare participation requirement in 
  2.30  paragraphs (c) and (d) to no less than 20 percent if the 
  2.31  commissioner of health determines that, due to the facility's 
  2.32  physical plant configuration, the facility cannot satisfy 
  2.33  Medicare distinct part requirements at the 50 percent 
  2.34  certification level.  To receive a reduction in the 
  2.35  participation requirement, a facility must demonstrate that the 
  2.36  reduction will not adversely affect access of Medicare-eligible 
  3.1   residents to Medicare-certified beds. 
  3.2      (f)  [INSTITUTIONS FOR MENTAL DISEASE.] The commissioner 
  3.3   may grant exceptions to the requirements of paragraph (b) for 
  3.4   nursing facilities that are designated as institutions for 
  3.5   mental disease. 
  3.6      (g)  [NOTICE OF RIGHTS.] The commissioner shall inform 
  3.7   recipients of their rights under this subdivision and section 
  3.8   144.651, subdivision 29.